Information Collection

DD Form 3040-4 - Administrative Review Checklist

IC 272947 under ICR 202412-0704-008 · OMB 0704-0560.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 3040-4 DD Form 3040-4 - Administrative Review Checklist	Form and Instruction
Form DD Form 3040-4 Administrative Review Checklist DD Form 3040-4 - Administrative Review Checklist	Form and Instruction
DD Form 3040-4 Administrative Review Checklist DD3040-4 draft 20241211.PDF	Form and Instruction
DD Form 3040-4 Administrative Review Checklist DD3040-4 draft 20241211.PDF	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DD Form 3040-4				No		Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35,173

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35,173	35,173
Annual IC Time Burden (Hours)	5,862	5,862
Annual IC Cost Burden (Dollars)	42,501	42,501

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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